Departments : Officer Survival

Cholesterol: Sorting Good From Bad

July 01, 2000
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by Lawrence Heiskell, M.D.

Breakfast of champions or meal of the damned? Know how to tell the difference.

Everybody needs it! But for some people, not only can it be harmful but it can be a potential killer. Cholesterol is a naturally occurring fat that basically functions as a building block for producing hormones and new cells for the body and insulating nerves. The liver can make all the cholesterol the body needs, but because cholesterol is found in all animal products, we ingest it when we consume meat and dairy products.

For those individuals who are geneti­cally predisposed to having cholesterol problems, a diet high in saturated fats is the main cause of high cholesterol levels in the blood.

What Happens To Cholesterol In the Blood?

While in the blood, cholesterol binds with protein molecules to form various types of lipoproteins. High-density lipo­proteins (HDL) transport excess choles­terol to the liver where it is then expelled in the form of bile. Low-density lipopro­teins (LDL) are larger and, have a tendency to stay in the body. The very-low-density lipoproteins transport triglycerides. Tri­glycerides store fatty acids, an essential source of energy for the body.

The inherent risk of developing cardio­vascular disease depends not only on how much cholesterol is in the blood but what type of cholesterol is present. For example, HDL (the good guys) has been associated with a decreased risk of cardiac disease. LDL (the bad guys) has been associated with an increased risk of dying from coro­nary heart disease. This type of cholesterol infiltrates the walls of the arteries and starts the inflammatory disease process known as atherosclerosis, which can eventually re­sult in stroke, heart disease, hypertension, as well as other cardiovascular disorders.

What Causes High Cholesterol?

High cholesterol is largely determined by genetics. Some individuals are geneti­cally blessed with low cholesterol, despite their dietary habits or lifestyle. Other indi­viduals, however, are not so fortunate and suffer from various hereditary disorders that significantly increase the risk for high cholesterol. The most common disorders are diabetes and obesity. Those individuals with the genetic predisposition, who eat foods high in saturated fats, are very likely to have high blood cholesterol levels.

How Do I Know If I Have High Cholesterol?

During your routine yearly checkup, your doctor can perform simple labora­tory blood tests to determine if you have high cholesterol.

A serum cholesterol reading below 200 is considered normal. Levels between 200 and 240 are considered borderline. Levels above 240 are considered high. The triglyceride level should be below 200.

What Is the Treatment for High Cholesterol?

The conventional approach for those individuals with serum cholesterol in the borderline to high-normal range consists of lifestyle, exercise and dietary changes. Additional measures may in­clude a natural cholesterol reduction plan based on a high-fiber dietary sup­plement, such as bran or psyllium.

Medical management, in which drugs are used to lower cholesterol, may be in­dicated if the cholesterol is above 240, despite an effort to make lifestyle and diet changes.

Prevention Is the Best Medicine

Consume foods that contain water­ soluble fiber. Foods that contain high fiber include apples, beans, carrots, cab­bage and oatmeal. Limit yourself to three eggs per week. and while cooking, replace butter and shortening - saturat­ed fats - with canola or olive oil-liq­uid monounsaturated fats. Vitamins and minerals that have reputed cholesterol­-lowering properties include Vitamins A, C and E., zinc, copper and calcium.

Above all try to watch your weight and if you smoke, quit! Be sure not to con­sume more than 30 percent of your calo­ries from fat and limit your cholesterol in­take to no more than 300 milligrams per day. Begin and maintain a regular exer­cise program. Have regular checkups and have your cholesterol checked periodical­ly, especially if you have a family history of high cholesterol, diabetes or obesity. Finally, avoid fast foods and try to eat more vegetables, fruits and grains.

Dr. Heiskell, a member of the POLICE Advisory Board, is a reserve police officer with the Palm Springs (Calif.) Police Department and the SWAT Team physician for that agency.

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